Please sign our company up for one year of your Corporate Veil Service.

Company ________________________________________________

By (Name & Title)_________________________________________

Address_________________________________________________

Address 2_______________________________________________

City ___________________________________________________

State_______                Zip Code _____________________________

Telephone _______________________________________________

Email ___________________________________________________

We agree to pay the annual fee of $350 upon receipt of your invoice

_______________________________________________

Signature of representative of Company

Send this order form to:

Thomas P. Roberts, J.D., LL.M., P.C.
1828 East Fort Union Blvd.
Salt Lake City, UT 84121

Or fax it to (801) 733-6656

Or e-mail the above information to troberts@burgoyne.com